Risk of mortality with concomitant use of tamoxifen and selective serotonin reuptake inhibitors: multi-database cohort study
Objective To compare differences in mortality between women concomitantly treated with tamoxifen and selective serotonin reuptake inhibitors (SSRIs) that are potent inhibitors of the cytochrome-P450 2D6 enzyme (CYP2D6) versus tamoxifen and other SSRIs.Design Population based cohort study.Setting Fiv...
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| Veröffentlicht in: | BMJ (Online) 2016-09, Vol.354, p.i5014-i5014 |
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| creator | Donneyong, Macarius M Bykov, Katsiaryna Bosco-Levy, Pauline Dong, Yaa-Hui Levin, Raisa Gagne, Joshua J |
| description | Objective To compare differences in mortality between women concomitantly treated with tamoxifen and selective serotonin reuptake inhibitors (SSRIs) that are potent inhibitors of the cytochrome-P450 2D6 enzyme (CYP2D6) versus tamoxifen and other SSRIs.Design Population based cohort study.Setting Five US databases covering individuals enrolled in private and public health insurance programs from 1995 to 2013.Participants Two cohorts of women who started taking tamoxifen. In cohort 1, women started taking an SSRI during tamoxifen treatment. In cohort 2, women were already taking an SSRI when they started taking tamoxifen.Main outcome measures All cause mortality in each cohort in women taking SSRIs that are potent inhibitors of CYP2D6 (paroxetine, fluoxetine) versus other SSRIs. Propensity scores were used to match exposure groups in a variable ratio fashion. Results were measured separately for each cohort and combined hazard ratios calculated from Cox regression models across the two cohorts with random effects meta-analysis.Results There were 6067 and 8465 new users of tamoxifen in cohorts 1 and 2, respectively. Mean age was 55. A total of 991 and 1014 deaths occurred in cohorts 1 and 2 during a median follow-up of 2.2 (interquartile range 0.9-4.5) and 2.0 (0.8-3.9) years, respectively. The pooled hazard ratio for death for potent inhibitors (rate 58.6/1000 person years) compared with other SSRIs (rate 57.9/1000 person years) across cohorts 1 and 2 was 0.96 (95% confidence interval 0.88 to 1.06). Results were consistent across sensitivity analyses.Conclusion Concomitant use of tamoxifen and potent CYP2D6 inhibiting SSRIs versus other SSRIs was not associated with an increased risk of death. |
| doi_str_mv | 10.1136/bmj.i5014 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5044871</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1835351465</sourcerecordid><originalsourceid>FETCH-LOGICAL-b432t-4d3375cf1d97c411c6a95471188871bf07466d39a0204fea3932b8de3afcb5293</originalsourceid><addsrcrecordid>eNp1kVFLHTEQhYNUVNQH_4AE2gf7sJpsks2uD4KItoJQEH0Os9lsb667yTXJ2l7wxzfXq2ILfZqB-XLmTA5CB5QcU8qqk3acH1tBKN9AO1SKqqA1Y58-9NtoP8Y5IaRksm4qsYW2S1k1XEi6g55vbXzAvsejDwkGm5b4l00zrL3TfrQJXMJTNCsiweh_2944DK7D0QxGJ_tkchd88s46HMy0SPBgsHUz29rkQzzF4zQkW3SQoIUspP0sb8IxTd1yD232MESz_1p30f3V5d3F9-Lmx7fri_ObouWsTAXvGJNC97RrpOaU6goawSWldV1L2vZE8qrqWAOkJLw3wBpWtnVnGPS6FWXDdtHZWncxtaPptHEpwKAWwY4QlsqDVX9PnJ2pn_5JCcJ5XpEFjl4Fgn-cTExqtFGbYQBn_BRV_mbBBOWVyOjnf9C5n4LL52Wq5HXJarFy9HVN6eBjDKZ_N0OJWsWqcqzqJdbMHn50_06-hZiBL2tg9eb_On8AYyusVw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1824823859</pqid></control><display><type>article</type><title>Risk of mortality with concomitant use of tamoxifen and selective serotonin reuptake inhibitors: multi-database cohort study</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><source>JSTOR Archive Collection A-Z Listing</source><creator>Donneyong, Macarius M ; Bykov, Katsiaryna ; Bosco-Levy, Pauline ; Dong, Yaa-Hui ; Levin, Raisa ; Gagne, Joshua J</creator><creatorcontrib>Donneyong, Macarius M ; Bykov, Katsiaryna ; Bosco-Levy, Pauline ; Dong, Yaa-Hui ; Levin, Raisa ; Gagne, Joshua J</creatorcontrib><description>Objective To compare differences in mortality between women concomitantly treated with tamoxifen and selective serotonin reuptake inhibitors (SSRIs) that are potent inhibitors of the cytochrome-P450 2D6 enzyme (CYP2D6) versus tamoxifen and other SSRIs.Design Population based cohort study.Setting Five US databases covering individuals enrolled in private and public health insurance programs from 1995 to 2013.Participants Two cohorts of women who started taking tamoxifen. In cohort 1, women started taking an SSRI during tamoxifen treatment. In cohort 2, women were already taking an SSRI when they started taking tamoxifen.Main outcome measures All cause mortality in each cohort in women taking SSRIs that are potent inhibitors of CYP2D6 (paroxetine, fluoxetine) versus other SSRIs. Propensity scores were used to match exposure groups in a variable ratio fashion. Results were measured separately for each cohort and combined hazard ratios calculated from Cox regression models across the two cohorts with random effects meta-analysis.Results There were 6067 and 8465 new users of tamoxifen in cohorts 1 and 2, respectively. Mean age was 55. A total of 991 and 1014 deaths occurred in cohorts 1 and 2 during a median follow-up of 2.2 (interquartile range 0.9-4.5) and 2.0 (0.8-3.9) years, respectively. The pooled hazard ratio for death for potent inhibitors (rate 58.6/1000 person years) compared with other SSRIs (rate 57.9/1000 person years) across cohorts 1 and 2 was 0.96 (95% confidence interval 0.88 to 1.06). Results were consistent across sensitivity analyses.Conclusion Concomitant use of tamoxifen and potent CYP2D6 inhibiting SSRIs versus other SSRIs was not associated with an increased risk of death.</description><identifier>ISSN: 1756-1833</identifier><identifier>ISSN: 0959-8138</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.i5014</identifier><identifier>PMID: 27694571</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adult ; Aged ; Antineoplastic Agents, Hormonal - therapeutic use ; Breast cancer ; Breast Neoplasms - drug therapy ; Breast Neoplasms - mortality ; Breast Neoplasms - psychology ; Cancer therapies ; Cohort Studies ; Enrollments ; Enzymes ; Female ; Health insurance ; Humans ; Medicaid ; Medicare ; Mental Disorders - drug therapy ; Mental Disorders - etiology ; Mental Disorders - mortality ; Middle Aged ; Mortality ; Pharmaceuticals ; Pharmacy ; Prescription drugs ; Propensity Score ; Regression Analysis ; Serotonin Uptake Inhibitors - adverse effects ; Serotonin Uptake Inhibitors - therapeutic use ; Tamoxifen - therapeutic use ; United States - epidemiology ; Womens health</subject><ispartof>BMJ (Online), 2016-09, Vol.354, p.i5014-i5014</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Copyright BMJ Publishing Group LTD Sep 30, 2016</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to 2016 BMJ</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b432t-4d3375cf1d97c411c6a95471188871bf07466d39a0204fea3932b8de3afcb5293</citedby><cites>FETCH-LOGICAL-b432t-4d3375cf1d97c411c6a95471188871bf07466d39a0204fea3932b8de3afcb5293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmj.com/content/354/bmj.i5014.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmj.com/content/354/bmj.i5014.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>114,115,230,314,780,784,885,3196,23571,27924,27925,77600,77631</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27694571$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Donneyong, Macarius M</creatorcontrib><creatorcontrib>Bykov, Katsiaryna</creatorcontrib><creatorcontrib>Bosco-Levy, Pauline</creatorcontrib><creatorcontrib>Dong, Yaa-Hui</creatorcontrib><creatorcontrib>Levin, Raisa</creatorcontrib><creatorcontrib>Gagne, Joshua J</creatorcontrib><title>Risk of mortality with concomitant use of tamoxifen and selective serotonin reuptake inhibitors: multi-database cohort study</title><title>BMJ (Online)</title><addtitle>BMJ</addtitle><description>Objective To compare differences in mortality between women concomitantly treated with tamoxifen and selective serotonin reuptake inhibitors (SSRIs) that are potent inhibitors of the cytochrome-P450 2D6 enzyme (CYP2D6) versus tamoxifen and other SSRIs.Design Population based cohort study.Setting Five US databases covering individuals enrolled in private and public health insurance programs from 1995 to 2013.Participants Two cohorts of women who started taking tamoxifen. In cohort 1, women started taking an SSRI during tamoxifen treatment. In cohort 2, women were already taking an SSRI when they started taking tamoxifen.Main outcome measures All cause mortality in each cohort in women taking SSRIs that are potent inhibitors of CYP2D6 (paroxetine, fluoxetine) versus other SSRIs. Propensity scores were used to match exposure groups in a variable ratio fashion. Results were measured separately for each cohort and combined hazard ratios calculated from Cox regression models across the two cohorts with random effects meta-analysis.Results There were 6067 and 8465 new users of tamoxifen in cohorts 1 and 2, respectively. Mean age was 55. A total of 991 and 1014 deaths occurred in cohorts 1 and 2 during a median follow-up of 2.2 (interquartile range 0.9-4.5) and 2.0 (0.8-3.9) years, respectively. The pooled hazard ratio for death for potent inhibitors (rate 58.6/1000 person years) compared with other SSRIs (rate 57.9/1000 person years) across cohorts 1 and 2 was 0.96 (95% confidence interval 0.88 to 1.06). Results were consistent across sensitivity analyses.Conclusion Concomitant use of tamoxifen and potent CYP2D6 inhibiting SSRIs versus other SSRIs was not associated with an increased risk of death.</description><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Agents, Hormonal - therapeutic use</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - psychology</subject><subject>Cancer therapies</subject><subject>Cohort Studies</subject><subject>Enrollments</subject><subject>Enzymes</subject><subject>Female</subject><subject>Health insurance</subject><subject>Humans</subject><subject>Medicaid</subject><subject>Medicare</subject><subject>Mental Disorders - drug therapy</subject><subject>Mental Disorders - etiology</subject><subject>Mental Disorders - mortality</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Pharmaceuticals</subject><subject>Pharmacy</subject><subject>Prescription drugs</subject><subject>Propensity Score</subject><subject>Regression Analysis</subject><subject>Serotonin Uptake Inhibitors - adverse effects</subject><subject>Serotonin Uptake Inhibitors - therapeutic use</subject><subject>Tamoxifen - therapeutic use</subject><subject>United States - epidemiology</subject><subject>Womens health</subject><issn>1756-1833</issn><issn>0959-8138</issn><issn>1756-1833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kVFLHTEQhYNUVNQH_4AE2gf7sJpsks2uD4KItoJQEH0Os9lsb667yTXJ2l7wxzfXq2ILfZqB-XLmTA5CB5QcU8qqk3acH1tBKN9AO1SKqqA1Y58-9NtoP8Y5IaRksm4qsYW2S1k1XEi6g55vbXzAvsejDwkGm5b4l00zrL3TfrQJXMJTNCsiweh_2944DK7D0QxGJ_tkchd88s46HMy0SPBgsHUz29rkQzzF4zQkW3SQoIUspP0sb8IxTd1yD232MESz_1p30f3V5d3F9-Lmx7fri_ObouWsTAXvGJNC97RrpOaU6goawSWldV1L2vZE8qrqWAOkJLw3wBpWtnVnGPS6FWXDdtHZWncxtaPptHEpwKAWwY4QlsqDVX9PnJ2pn_5JCcJ5XpEFjl4Fgn-cTExqtFGbYQBn_BRV_mbBBOWVyOjnf9C5n4LL52Wq5HXJarFy9HVN6eBjDKZ_N0OJWsWqcqzqJdbMHn50_06-hZiBL2tg9eb_On8AYyusVw</recordid><startdate>20160930</startdate><enddate>20160930</enddate><creator>Donneyong, Macarius M</creator><creator>Bykov, Katsiaryna</creator><creator>Bosco-Levy, Pauline</creator><creator>Dong, Yaa-Hui</creator><creator>Levin, Raisa</creator><creator>Gagne, Joshua J</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group Ltd</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160930</creationdate><title>Risk of mortality with concomitant use of tamoxifen and selective serotonin reuptake inhibitors: multi-database cohort study</title><author>Donneyong, Macarius M ; Bykov, Katsiaryna ; Bosco-Levy, Pauline ; Dong, Yaa-Hui ; Levin, Raisa ; Gagne, Joshua J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b432t-4d3375cf1d97c411c6a95471188871bf07466d39a0204fea3932b8de3afcb5293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic Agents, Hormonal - therapeutic use</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - mortality</topic><topic>Breast Neoplasms - psychology</topic><topic>Cancer therapies</topic><topic>Cohort Studies</topic><topic>Enrollments</topic><topic>Enzymes</topic><topic>Female</topic><topic>Health insurance</topic><topic>Humans</topic><topic>Medicaid</topic><topic>Medicare</topic><topic>Mental Disorders - drug therapy</topic><topic>Mental Disorders - etiology</topic><topic>Mental Disorders - mortality</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Pharmaceuticals</topic><topic>Pharmacy</topic><topic>Prescription drugs</topic><topic>Propensity Score</topic><topic>Regression Analysis</topic><topic>Serotonin Uptake Inhibitors - adverse effects</topic><topic>Serotonin Uptake Inhibitors - therapeutic use</topic><topic>Tamoxifen - therapeutic use</topic><topic>United States - epidemiology</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Donneyong, Macarius M</creatorcontrib><creatorcontrib>Bykov, Katsiaryna</creatorcontrib><creatorcontrib>Bosco-Levy, Pauline</creatorcontrib><creatorcontrib>Dong, Yaa-Hui</creatorcontrib><creatorcontrib>Levin, Raisa</creatorcontrib><creatorcontrib>Gagne, Joshua J</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ (Online)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Donneyong, Macarius M</au><au>Bykov, Katsiaryna</au><au>Bosco-Levy, Pauline</au><au>Dong, Yaa-Hui</au><au>Levin, Raisa</au><au>Gagne, Joshua J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of mortality with concomitant use of tamoxifen and selective serotonin reuptake inhibitors: multi-database cohort study</atitle><jtitle>BMJ (Online)</jtitle><addtitle>BMJ</addtitle><date>2016-09-30</date><risdate>2016</risdate><volume>354</volume><spage>i5014</spage><epage>i5014</epage><pages>i5014-i5014</pages><issn>1756-1833</issn><issn>0959-8138</issn><eissn>1756-1833</eissn><abstract>Objective To compare differences in mortality between women concomitantly treated with tamoxifen and selective serotonin reuptake inhibitors (SSRIs) that are potent inhibitors of the cytochrome-P450 2D6 enzyme (CYP2D6) versus tamoxifen and other SSRIs.Design Population based cohort study.Setting Five US databases covering individuals enrolled in private and public health insurance programs from 1995 to 2013.Participants Two cohorts of women who started taking tamoxifen. In cohort 1, women started taking an SSRI during tamoxifen treatment. In cohort 2, women were already taking an SSRI when they started taking tamoxifen.Main outcome measures All cause mortality in each cohort in women taking SSRIs that are potent inhibitors of CYP2D6 (paroxetine, fluoxetine) versus other SSRIs. Propensity scores were used to match exposure groups in a variable ratio fashion. Results were measured separately for each cohort and combined hazard ratios calculated from Cox regression models across the two cohorts with random effects meta-analysis.Results There were 6067 and 8465 new users of tamoxifen in cohorts 1 and 2, respectively. Mean age was 55. A total of 991 and 1014 deaths occurred in cohorts 1 and 2 during a median follow-up of 2.2 (interquartile range 0.9-4.5) and 2.0 (0.8-3.9) years, respectively. The pooled hazard ratio for death for potent inhibitors (rate 58.6/1000 person years) compared with other SSRIs (rate 57.9/1000 person years) across cohorts 1 and 2 was 0.96 (95% confidence interval 0.88 to 1.06). Results were consistent across sensitivity analyses.Conclusion Concomitant use of tamoxifen and potent CYP2D6 inhibiting SSRIs versus other SSRIs was not associated with an increased risk of death.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>27694571</pmid><doi>10.1136/bmj.i5014</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Antineoplastic Agents, Hormonal - therapeutic use Breast cancer Breast Neoplasms - drug therapy Breast Neoplasms - mortality Breast Neoplasms - psychology Cancer therapies Cohort Studies Enrollments Enzymes Female Health insurance Humans Medicaid Medicare Mental Disorders - drug therapy Mental Disorders - etiology Mental Disorders - mortality Middle Aged Mortality Pharmaceuticals Pharmacy Prescription drugs Propensity Score Regression Analysis Serotonin Uptake Inhibitors - adverse effects Serotonin Uptake Inhibitors - therapeutic use Tamoxifen - therapeutic use United States - epidemiology Womens health |
| title | Risk of mortality with concomitant use of tamoxifen and selective serotonin reuptake inhibitors: multi-database cohort study |
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